{"id":4203,"count":2,"description":"<strong>Tuberculoza (TB)<\/strong> r\u0103m\u00e2ne una dintre cele mai mortale boli infec\u021bioase la nivel global \u2014 OMS estimeaz\u0103 c\u0103 10,6 milioane de persoane au \u00eemboln\u0103vit de tuberculoz\u0103 \u00een 2022 \u0219i 1,3 milioane au decedat, inclusiv 167.000 cu coinfec\u021bie HIV. Boala este cauzat\u0103 de <em>Mycobacterium tuberculosis<\/em>, un bacil intracelular cu cre\u0219tere lent\u0103 care afecteaz\u0103 \u00een primul r\u00e2nd pl\u0103m\u00e2nii, dar poate implica aproape orice sistem de organe. <strong>Terapia modern\u0103 cu curs scurt pentru tuberculoz\u0103 este complet vindec\u0103toare \u2014 dar numai atunci c\u00e2nd este utilizat\u0103 corect<\/strong>: combina\u021bia corect\u0103 de medicamente, la doza potrivit\u0103, pe \u00eentreaga durat\u0103, sub supraveghere specializat\u0103. Aceast\u0103 pagin\u0103 enumer\u0103 medicamentele antituberculoase disponibile la MedsBase. <strong>Nu este un ghid de auto-tratament pentru tuberculoz\u0103 activ\u0103.<\/strong>\nThe 4-drug RIPE regimen\nThe WHO standard regimen for new, drug-susceptible pulmonary tuberculosis is six months in two phases:\n<strong>Faza intensiv\u0103 \u2014 2 luni:<\/strong> Rifampicin\u0103 + Izoniazid\u0103 + Pirazinamid\u0103 + <strong>Etambutol<\/strong> (RIPE), toate cele patru medicamente zilnic.<strong>Faza de continuare \u2014 4 luni:<\/strong> Rifampicin + Isoniazid (RH), continued daily.\nLonger regimens (9&ndash;12 months) apply to TB meningitis, bone and joint TB, and disseminated disease. Treatment is supervised &mdash; <strong>terapia direct observat\u0103 (DOT)<\/strong> is recommended in most national programmes to ensure adherence and to prevent the emergence of multidrug-resistant TB (MDR-TB).\nWhy combination therapy is mandatory\nSingle-agent treatment of active TB inevitably selects for resistant organisms. The bacterial load in a cavitating pulmonary lesion is enormous (up to 109 bacilli) and naturally occurring resistance mutations exist at low frequency for every drug. Using one drug kills the susceptible majority and leaves the resistant minority to multiply &mdash; treatment failure with a now-untreatable strain. <strong>Terapia combinat\u0103<\/strong> func\u021bioneaz\u0103 deoarece probabilitatea ca un organism s\u0103 fie simultan rezistent la multiple medicamente este extrem de mic\u0103. Acesta este motivul pentru care fiecare pagin\u0103 din aceast\u0103 categorie con\u021bine un avertisment explicit c\u0103 achizi\u021bionarea cu un singur agent este potrivit\u0103 <strong>doar<\/strong> for ongoing supervised regimen continuation, latent TB infection (4-month rifampicin monotherapy), or specific non-TB indications such as leprosy, MAC, or meningococcal prophylaxis.\nMultidrug-resistant TB &mdash; a warning\nMDR-TB &mdash; resistance to at least rifampicin and isoniazid &mdash; affected an estimated 410,000 people worldwide in 2022. MDR-TB requires longer treatment (9&ndash;20 months) with second-line agents including <strong>fluorochinolone<\/strong> (levofloxacin\u0103, moxifloxacin\u0103), <strong>linezolid<\/strong>, <strong>bedaquilin\u0103<\/strong>, \u0219i <strong>clofazimin\u0103<\/strong>. MDR-TB is the predictable downstream result of partial, irregular, or single-agent treatment of drug-susceptible TB. Cure is possible but harder, more expensive, and more toxic than first-line therapy &mdash; the case for getting the initial regimen right and completing it.\nAnti-TB medications stocked at MedsBase\nThis category currently lists <strong>dou\u0103 dintre cele patru agen\u021bi de prim\u0103 linie<\/strong>:\n<a href=\"https:\/\/medsbase.com\/ro\/r-cin\/\"><strong>R-Cin<\/strong><\/a> \u2014 <strong>rifampicin\u0103 300\/450\/600 mg<\/strong> (Cipla). Cel mai important medicament sterilizant \u00een terapia TB. Utilizat \u0219i ca monoterapie de 4 luni pentru infec\u021bia latent\u0103 cu TB (regimul 4R), \u00een terapia multi-drug pentru lepr\u0103 multibacilar\u0103, pentru profilaxia contactului meningococic \u0219i \u00een infec\u021biile grave stafilococice ale osului, articula\u021biilor sau ale dispozitivelor protezice. Rifampicina este un <strong>inducer major al CYP3A4 \/ CYP2C9 \/ CYP2C19<\/strong> \u2014 reduce eficacitatea zeci de medicamente administrate concomitent, inclusiv contraceptivele orale, warfarina, DOAC, statinele, metadona, imunosupresoarele pentru transplant, antiretroviralele \u0219i multe altele. <strong>Dezv\u0103luie \u00eentotdeauna fiecare medicament luat concomitent \u00eenainte de a \u00eencepe tratamentul.<\/strong> Cauzeaz\u0103 decolorare portocalie-ro\u0219ie a urinei, transpira\u021biei, lacrimilor \u0219i salivei (inofensiv\u0103 dar pateaz\u0103 permanent lentilele de contact moi).<a href=\"https:\/\/medsbase.com\/ro\/combutol\/\"><strong>Combutol<\/strong><\/a> \u2014 <strong>etambutol HCl 200\/400\/800 mg<\/strong> (Lupin). Un agent bacteriostatic al c\u0103rui rol \u00een regim este de a suprima apari\u021bia rezisten\u021bei la medicamentele bactericide partenere. De asemenea, un agent esen\u021bial pentru infec\u021bia cu complexul Mycobacterium avium (MAC) \u00een HIV. Toxicitatea definitorie este <strong>neurita optic\u0103 dependent\u0103 de doz\u0103<\/strong>: pierderea acuit\u0103\u021bii vizuale \u0219i a discrimin\u0103rii culorilor ro\u0219u-verde, de obicei reversibil\u0103 dac\u0103 medicamentul este oprit la primul simptom, dar poten\u021bial permanent\u0103 dac\u0103 nu este oprit. <strong>Evaluarea oftalmologic\u0103 de baz\u0103 + verific\u0103ri vizuale lunare sunt obligatorii.<\/strong> Renal-dose adjustment is essential.\nThe other two first-line agents &mdash; <strong>izoniazid\u0103<\/strong> \u0219i <strong>pirazinamid\u0103<\/strong> &mdash; are not currently stocked at MedsBase. Patients on a full RIPE regimen will need to source these from another supplier, a hospital pharmacy, or their national TB programme. National TB programmes in most countries provide first-line TB drugs free of charge.\nMandatory monitoring during TB therapy\n<strong>Func\u021bia hepatic\u0103<\/strong> \u2014 la \u00eenceput \u0219i cel pu\u021bin lunar. Rifampicina, izoniazida \u0219i pirazinamida sunt hepatotoxice; regimul combinat poate provoca hepatit\u0103 clinic semnificativ\u0103 la aproximativ 5% dintre pacien\u021bi. \u00centrerupe\u021bi regimul \u0219i consulta\u021bi un medic \u00een cazul apari\u021biei icterului, urinei \u00eentunecate sau durerii \u00een cadranul superior drept.<strong>Acuitatea vizual\u0103 \u0219i vederea culorilor<\/strong> \u2014 la \u00eenceput \u0219i lunar \u00een timpul administr\u0103rii etambutolului. \u00centrerupe\u021bi etambutolul imediat \u00een cazul oric\u0103rei noi pl\u00e2ngi vizuale.<strong>Examen microscopic \u0219i cultur\u0103 de sput\u0103<\/strong> \u2014 principalul marker de eficacitate pentru TB pulmonar\u0103 activ\u0103; conversia la cultur\u0103 negativ\u0103 \u00een 2 luni indic\u0103 un r\u0103spuns bun.<strong>Func\u021bia renal\u0103 \u0219i acidul uric seric<\/strong> \u2014 eliminarea etambutolului este renal\u0103; pirazinamida cre\u0219te acidul uric \u0219i poate precipita gut\u0103.<strong>Statut HIV<\/strong> &mdash; TB-HIV co-infection alters the regimen, the drug interactions, and the prognosis. Every patient with active TB should be offered HIV testing.\nWho this category is not for\nIf you have suspected active TB (chronic cough &gt; 3 weeks, weight loss, night sweats, blood-stained sputum) you need a TB specialist, sputum testing, susceptibility testing, contact tracing, and combination therapy under directly observed treatment &mdash; <strong>nu autotratament cu un singur medicament<\/strong>. TB activ\u0103 netratat\u0103 sau tratat\u0103 par\u021bial este contagioas\u0103, ucide aproximativ jum\u0103tate dintre cei infecta\u021bi \u0219i este cel mai comun factor care determin\u0103 TB-MDR. Folosi\u021bi aceast\u0103 pagin\u0103 pentru re\u00eennoiri \u0219i continuarea unui regim supravegheat existent, pentru tratamentul infec\u021biei latente cu TB sau pentru indica\u021biile specifice non-TB enumerate pe fiecare pagin\u0103 de produs.","link":"https:\/\/medsbase.com\/ro\/tuberculosis-treatment\/","name":"Tratament pentru tuberculoz\u0103","slug":"tuberculosis-treatment","taxonomy":"product_cat","parent":3223,"meta":[],"menu_order":0,"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat\/4203","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/taxonomies\/product_cat"}],"up":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat\/3223"}],"wp:post_type":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product?product_cat=4203"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}